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N RECEIVEDl r Rte,, <br /> AUG 12 2013 <br /> w ENVIRONMENTAL HEALTH <br /> PERMITISERVICES <br /> a San Joaquin Public Health Services Report for the month of 2D[5 <br /> Environmental Health Services <br /> PO Box 2049 (445 N.San Joaquin St.) Septic Tank and Cesspool Submitted by. <br /> Stockton,California,9S209 Cleaners Report <br /> Fax:4640138 Address:(oS83 SAryorf W4y, Aorrk= <br /> 0 <br /> Must be submitted by the 12;"of each month <br /> 0 <br /> Ln(Y) Date Name of Property Owner Address where work was performed type waste gal.pumped disposal site <br /> CO <br /> keLTu - J ' <br /> p "i5[.t/ 7l tc U rl tr <br /> N — ( C�- S 252-2, f 5 a C7 it u <br /> Z vio l d r e►r U <br /> _Z tL � <br /> E20A�LILUW)rEZIC Rd I Doo It <br /> -- 116-30t t 5 �e Q i 3 00 It cs <br /> r R5 2 : �6 j z t; 3gDO <br /> H V, St 000 �l "� <br /> a 1 iCc i'1 MEE <br /> S �Szi rc t t z <br /> �c u <br /> U) 21 st �t cc U <br /> 4L4 &y& 5 rt q lk d1 C-1 <br /> ` r a C <br /> N <br /> 7 2 ►a - I.c ti rc a <br /> Ln <br /> H 1 2&Ye tT Pla, tc rr COD !( d <br /> 2:3 ELS 6 -5tt 1( I Obo �< Y <br /> The following excerpt from the code of Federal Regulations.Section 403"Report must be signed by a corporate officer who can kegs bind the <br /> — <br /> 0 N comGpa ny" <br /> certify under penalty of law that this docurnent and all attachments were prepared under my direction or supervision. <br />. . . . . <br />